Life Sign Network

Our project focuses on solving a recurrent problem in one of Latin America’s most fragile regions: the reachability of some patients in the Amazon, where the high prevalence of cardiovascular diseases associated with specific geography, socioeconomic factors, and a river-based transport system—which results in days of travel between cities—creates a very particular and difficult situation. This arrangement creates an enormous gap between patients, who must be followed up, and the health teams that must follow them.

Cardiovascular diseases are a worldwide problem; hypertension alone affects 1.3 billion people currently. In 2020, the Brazilian Public Health System spent $2 billion in hospitalization and medicines on its 52,4 million hypertensive patients. In this delicate region, this scenario is even worse due to diet and cultural factors, such as the use of salt to keep protein fresh for longer in areas with no electrical power. In this area, where the prevalence of hypertensive men is around 28% and 23% for women, it reaches 67% in the elderly population.

In urban areas, only 40% of these hypertensive patients are currently under control, a number that is likely much worse in isolated areas due to a lack of appropriate diagnoses, treatment, and follow-up. In 2020, 29 million people live in the Brazilian Amazon, with 4 million of those in rural areas, where only 16% have access to the internet at home due to the high cost, difficult installation, and instability.

This population is remarkably arranged nearby and along the riverbanks during its course, using a sole river-based transportation system. This "liquid territory" changes seasonally and makes it even harder to travel during certain periods. Besides this, there is also electrical and connection isolation in the river course, which is only available near larger villages.

All these factors create a very complex situation, which results in inefficient, expensive, and laborious health assistance with several difficulties for capillarization. The teams, designated by the Ministry of Health and municipalities, spend weeks traveling by ship, going village by village, and trying to examine the largest possible number of patients at a time, since the next time they will return to that region again will be months later. This precious time is mostly used for resolving patient complaints and analyzing basic vital signs to adjust medications.

In emergency scenarios, people are transported thousands of kilometers to big cities with health infrastructure, sometimes taking more than 24 hours. Therefore, most patients do not get timely emergency care. For those who make it, there is an astronomical financial burden —totaling U$ 30.000,00 per person transported in a country with a minimum of U$ 236,00—and the patients are usually in critical condition due to this delay. Many patients die before reaching assistance.

All factors discussed above affect mortality rates. Research shows these populations have higher mortality rates than those in urban areas. This difference is colossal—sometimes 10 times more—when compared to developed countries. The government has historically tried to figure this problem out with no success.

In order to solve this multiple-layer problem, our solution also has multiple layers of approaches and makes new use of some existing technologies in an innovative manner, reducing the gap between patients and the health system. To do so, we will work complementarily with local healthcare teams and systems, creating a more efficient way to provide continuous healthcare to this population.

Our strategy consists of providing families in this area with a diagnosis of cardiovascular disease with a kit that includes three inexpensive and existing sensors (glucometer, sphygmomanometer, and oximeter) at a total cost of $37,50. These sensors are synchronized with the mobile application installed on their cellphones, since most of these families have at least one smartphone to communicate when going to big villages.

This application is intuitive and developed with the illiterate in mind. It also contains educational content focused on healthy habits, diet (with optional healthy dishes of local cuisine), and avoidance of smoking or drinking to focus not only on the family member that already has a disease but also on lifestyle changes for all the patients, aiming for primary and secondary prevention care.

It allows families to monitor blood pressure and other parameters without having to annotate, remember, or get lost in the numbers because all the synchronization happens automatically. This data is saved on the patient’s phone and syncs automatically with our platform and become available to health teams responsible for that area. For those in no signal area, a small device (at a cost of $30,00) connects patients with our network.

This synchronization allows for continuous follow-up, evaluation of the effectiveness of treatment, and feedback using specific channels inside our app with the technology explained below.

For this continuous data exchange, our solution includes a low-cost long-range (LoRa) decentralized network, where every patient works as a bridge to connect the subsequent ones to the network. This long-range network arrangement allows data to be collected and send using multiple paths, chosen automatically, and provides a constant and robust low-data connection. The distance between these nodes can be as much as hundreds of kilometers, depending on the environment, making them excellent for our approach.

In addition to this robust and continuous but relatively slow connection, there is also a satellite link provided by StarLink antennas installed on the boats that already pass by these families daily, transporting cargo or people between cities. It creates a few minutes of high-speed connection every day that will be used for bigger data transfers, video-based telemedicine, and as a backup path to data synchronization with the health team.

As explained before, our goal is to optimize the already existing healthcare organization and infrastructure by reducing the well-known gap problem in our region. As an example, there are currently several telemedicine centers that provide healthcare to this population. However, they are very poorly utilized due to the connection problems and the physical distance, which requires several days of travel to reach these patients.

Our solution serves the people living nearby and along the riverbank,  traditional populations, who only get checked up on their health every couple of months when the Primary Health Care Team approaches them to assist these populations in very specific demands and check their vital signs, sometimes making changes in medications, [based on a static view captured at that moment,] that cannot be tracked to see if they worked due to the fact that by the time another health team reaches them it will be months or years later.

The Life Sign project will impact their lives by filling the existing gap between these populations and the health care team. It also allows them to be able to check their glucose and blood pressure in an easy way through the kits distributed, and the information of those signs shared automatically with our app will be accessible to the health care team that already assists them, so any sort of concerning change in these signs will be assessed by the team so that necessary changes in medication or instructions to look for a healthcare facility will be transmitted to the patient via app.

Furthermore, our app will also contain educational videos about lifestyle habits to improve control of the disease and overall wellbeing that can be watched by the whole family. Our app will be intuitive and easy to use due to the lower level of education of most of these people. We will also partner with indigenous people who also speak Portuguese to offer our educational videos in the local indigenous languages, to increase accessibility.

 The healthcare team will be able to track any concerning signs and make the right changes in medication without having to wait many months before seeing the patient again, as well as tightening the contact between the health care team and patient, it will also serve as an educational platform that will actively aim to improve the control of the disease of those in the family with  existing conditions as well as improve the quality of life of those people. 

 Thus, it will serve as not only primary but also secondary prevention of health, which will be more cost effective for the Health System, saving thousands of dollars each year. When the system is in fully functional, the price that would fund one transportation in an emergency context ($30.000) will be able to track vital sings of 25.000 families per month. 

By having this robust approach, we will create a positive impact on these health professionals by optimizing their work for high-complexity tasks that are nowadays only done physically. It will also enable them to serve more areas at a timeand focus their attention to those who really need it, creating strategies specifically for them based on the collected information. In the end, superior health assistance will be provided to everyone at a lower cost, because of the focus on the prevention rather than on high-complexity emergence management in remote area. 

Our team is composed of people who live in the Amazon and are aware of the real conditions and complexities of this region, especially when it comes to health in fragile contexts. With a team of experts,composed of medical students, a cardiologist, a computer engineer, an obstetrician, and a marine engineer with experience in logistics, our team has the know-how necessary to tackle the healthcare knowledge and logistics needed in order to make these solutions work.

 The proximity of medical students from the Federal University of Amazonas with the reality of these isolated areas and services, such as the Telemedicine Center provided by the university hospital, is helping us integrate the proposed solution with the existing health infrastructure that is underutilized to make a greater impact with our project.

In favor of building the application interface, keeping in mind that it must be easy to use and intuitive, we have a computer engineer that already has vast experience developing apps and creating well thought product design. We are also working on a voice accessibility function so that illiterate people will be able to use it as well, not only in Portuguese but also in their native languages.

To make the educational videos for the platform, our team is charged with the most recent evidence about cardiovascular diseases to showcase the best ways to control existing diseases, as well as to have a healthy lifestyle. Our team has a large experience working with volunteer programs that have close contact with less affortunate populations, so we can create content that’s easy to understand while also sharing important information to this population. 

We have the main telehealth service in the region linked to our university and we are currently sharing experiences. The main developers of a big program that supports pregnant women in remote areas, an obstetrician, and a surgeon shared technical challenges, implementation process difficulties, and ways they communicate with authorities in these areas. Their know-how in this field is valuable to take into account so that our solution is well thought out and we face less difficulties in the implementation process by already foreseeing challenges and also planning the best way to get in touch with the authorities and population.    

To assess the dynamics of the local naval hub and the difficulties of inland navigation and peculiarities of waterway transport in the Amazon region, we have a marine engineer. Through the application of technical concepts and the norms of the maritime authority, the Brazilian Navy, the study has technical and normative support to be developed. Moreover, the engineer inserted in the local shipping market knows the peculiarities of intercity navigation, increasing the reliability of the study in relation to the dynamics of local navigation. In short, the presence of a naval engineer is essential to ensuring logistical feasibility and successful implementation in the region.

Our team still requires more people with experience in networks and technology of information, as well as business. We intend to find these people after funding. 

Our solution consists of multiple steps to enhance the reachability and efficiency of healthcare by reducing the gap between patients and the healthcare system. Currently, these multiple steps have passed the stage of concept and are being tested, in different stages of maturity, in simulated and real-world conditions.

We understand that our approach is very audacious, and other attempts have failed in the past. Therefore, we decided to start with the hardest part and main barrier, which is the network infrastructure and hardware needed to surpass the physical distance and isolation inherent to our problem.

Presently, we already have a functioning network in Amazonas State that is independent of internet connections and the power grid. We achieve it by using a decentralized infrastructure in which every device (a radio with a LoRa protocol connection) is a hub to connect the others, creating a robust mesh connection. We also had extreme conditions in mind when we developed this system, which is entirely solar-powered and portable, in a region that changes seasonally and has one of the greatest solar irradiation indexes in the world. This allows for immediate use since it is preset to connect automatically to our network.

In order to simulate the environment of boats traveling by the river, we used our drones equipped with one of these small devices that transmit long-range signals that connect to multiple autonomous antennas (which are based on LoRa protocol and have Bluetooth to connect to the cellphone, like a WI-FI router, but instead of the internet, it connects to our long-range network) arranged in different locations in the city and outside it.

Our platform is also being developed as a prototype, with some basic functions already operating. It is being constantly modified to improve the user experience, reliability, and features. When it comes to the data migration from the sensors (glucometer, sphygmomanometer, and oximeter), we are currently working on ways to optimize this synchronization with our platform efficiently after being read by these instruments. Some manufacturers create barriers that make this migration difficult and demand some extra steps. So we are putting extra effort into this.

Working closely with the experts from the Federal University of Amazonas Telemedicine Center also facilitates our communication with different cities in our state to implement new features based on specific demands, such as using native language voice in our app to better interact with the indigenous population, which represents a significant percentage of the total in some cities. It is also creating a well-suited prototype that can be used more widely when we start our tests with a small number of patients with the help of the Telehealth Center.

Currently, we are in the prototype phase and have not reached the public yet. However, we are preparing for our pilot study, which will serve 75 families and expand to 150 in each of the 10 zones after the second year (reaching approximately 9000 people).

Historically, MIT Solve has given people real opportunities to innovate and create a better future in their context and globally.

 Being residents of one of the poorest regions in a developing country, such as Brazil, has always limited our attempts to create solutions to our real-life problems due to restrictions ranging from geographic isolation to economic limitations. Our team is composed mostly of experts with experience in our healthcare context who also appreciate technology and understand that its place in a digital world (especially with the fourth industrial revolution) can be the biggest instrument for equalizing health access in centuries.

By working in our hospitals, we can see how inequitable this health access can be. We can also feel the bad experiences and pain this population suffers during their journey searching for care. This difficulty is not limited to patients but also to the healthcare team, and a lot of these problems could be solved if we utilized technologies in better and more efficient ways, especially in healthcare. Sometimes spending 14 days of ship travel for an appointment that lasts 15 minutes and could be done remotely is a burden on the health system and also on patients time and quality of life.

Being nonconformist with the present arrangement and dynamics in health access and how they drive unequal and poor assistance, as in other areas, is a powerful tool that induces innovation and different ways of thinking in order to solve historical problems.

There is no better institution in the world that aggregates knowledge, principles, and a strong connection between the biggest centers of technology development. So, this is the reason why our team is trying to reach this network to help with our project implementation and consequently improve the lives of those who are invisible to most of the world.

We are sure that this arrangement of already existing technologies applied to solve this specific problem is a great approach that could also be modified to work in different environments that, for some reasons, have isolation, poverty, and difficult access as problems, like some regions in Latin America, the Middle East, Central Africa, and Southeast Asia. So, it is important to have the best directions, such as those provided by MIT’s experts and its network.

Our solution uses some existing technologies in an innovative manner with a novel arrangement. When we were developing the solution, we knew it had to be something low-cost and easy to use, especially in our context, where a significant number of our users are illiterate or indigenous.

As said before, our target problem is multifactorial and must be solved as such. By creating the possibility for these patients to analyze their basic life signs, such as blood pressure, glucose levels, and blood oxygenation (which is done extensively worldwide), we only overcome part of the problem. The connection and isolation problems are the real challenges to resolve. This is why our solution also contemplates this part of the bigger issue.

When it comes to connection in remote areas, the easiest way is to utilize a satellite connection. However, when the cost is taken into consideration, it is unpractical to utilize one antenna plus service fees per user or per group of users. Having this in mind, we analyzed the dynamic of this region (from social to economic and physical) and thought about what the main common point was between all these families.

So, we concluded that a river-based transportation system was the answer. The ships passing daily in front of these families could be used as a common point of reference. These ships could be equipped with a direct link to a satellite, and, when equipped with a robust set of antennas, they could create a radius of signal that would allow each point in its course to be connected for some minutes (9 minutes to be precise) each time the ship passes through it.

However, this connection alone can be narrow, especially for medical purposes. To solve this issue, we developed the second part of our connection approach. Using long-range (LoRa) devices that connect as nodes in a mesh network, also connecting to patients’ phones, we offer a robust secondary network that is slow and has limited bandwidth but, on the other hand, is very stable and can connect patients for hundreds of kilometers.

This hybrid model is ideal in this context. When combined with a platform that collects vital signs from these patients in a very intuitive and easy way (due to its automatic synchronization), it can offer a very useful tool for a multidisciplinary team's prospective follow-up.

This arrangement of already existing technologies, never combined at such a level for medical purposes in a very needy region, is original and novel, particularly when the costs are covered (by far) by the amount of money the public health system will save.

Our impact in the short term—such as in the next year—will be initial but remarkable. We have plans to start testing our system—which is in the final phase of internal tests with our hardware prototypes currently being tested for work in extreme conditions only using solar power—in the next few months with real families in partnership with some local health administrators in a defined area in the extreme interior of Amazonas State in Brazil.

During the first year, we hope to start seeing the situation of these families improve. This is our main goal. Another goal is improving our system with increments on our team, which today is very dedicated but, for obvious reasons, doesn’t have the total experience needed for the future phases of our expansions. The incorporation of new members with specific skills will put our project on another level when it comes to delivering the best product possible to our patients, healthcare providers, and the public system.

 We also hope to create not just a better team in terms of hard skills but also when it comes to fraternity, humanity, and a sense of family—where everyone feels comfortable acting, innovating, and disagreeing constructively—in our project.

 To achieve these goals, we are trying to connect ourselves with experts and have the appropriate guidance and cooperation. Participating in MIT Solve is one of these attempts.

 For the middle term (the next five years), our goal is to successfully overcome the most difficult part, which is the initial implementation (phase 1), and start expanding our solution for several regions (phase 2), with thousands of people being helped and having their lives improved by our product. Phase 2 starts after the first year and ends two years later.

Due to the natural maturation process, in phase 3, our most sophisticated prototypes of unmanned ships should be working in the next few years. Our financial sustainability is reached in this phase, after the third year after implementation. We are focusing on these long-term developments now because we know that even with a great and robust idea, there is room for improvement, and using these technologies, we will be able to create a much more reliable and robust network. In order to achieve this, studies are being done, and we are working on the construction of our first drone equipped with a satellite antenna with a cheaper technology than Starlink for low-data connections.

 During the second year (phase 2), our costs will be $3,72 per family per month, and after the third year, a decrease of more than half of the price occurs, so it will be $2.00 per family per month. All costs were calculated counting StarLink antennas; with our progress toward a satellite antenna with cheaper technology, this cost will decrease even further. Therefore, during years four and five (phase 3), we intend to implement our solution for a maximum of $1.20 per family per month, but there's room for reductions.

Our plan of implementation, which starts before the prototyping phase, is well defined and establishes some important marks, not just focused on economic growth but also on consolidation of our technology, increments in our team, and the development of new paths (such as those mentioned before) to ensure the best utilization of resources and better service for everyone utilizing our system.

So, by comparing our current marks with our original plan, we can interpret if something is going slower than expected or faster than we anticipated. We did not start testing out the product with patients due to some ethical and legal approvals. We also want to ensure our platform is as stable as it can be when reaching patients, particularly those who live in remote areas and may need our solution in life-threatening situations.

Another thermometer used to identify if our operations are going according to plan is how our current partners, such as prefectures, telemedicine centers, and healthcare teams, interpret and interact with our product or prototype.

 As a project with no funders yet, we are currently using our own capital to develop these technologies and maintain the course. So, we understand that sometimes it will be a factor that implies delays (which have not happened so far but are a possibility).

Our solution, as said before, is focused on primary and secondary prevention. It is well known in the academic field—especially in healthcare—how positive and truly resolute it is to invest in prevention instead of trying to solve problems in their late stages of development (usually with proportions much bigger).

The backbone of our strategy is offering healthcare for people historically disconnected from the system, but the main objective of doing this is to reduce the evolution of the problem (cardiovascular diseases, in this case). Support for emergencies is an additional feature that improves the chain of support. However, the biggest results over time will come with the prospective follow-up. 

By implementing a system such as this, it is possible to improve the health and, consequently, the quality of life of these populations. This personal value, which can be very subjective, has the power to modify an entire life with a small initial change (not just for the patient but for healthcare teams and the functioning of our health system).

 Patients, with better health assistance, can experience a physical health improvement and a sense of being important and someone who deserves attention. It can create a positive impact that is transmitted from that moment into the future. When this logic is applied in a familiar context, the potential is even bigger. Physical improvement is responsible for another kind of transformation in cardiovascular diseases: proportionately, patients execute activities they stop doing due to their disease and its metabolic implications; moreover, they live longer.

 With better control of their diseases and constant assistance, fewer people will develop aggravating outcomes, such as acute myocardial infarction. Therefore, our solution, which at first seems solely focused on controlling the disease, will also impact the outcomes of patients and reduce mortality since most patients in interior regions in an urgency context don't make it until they get to bigger cities in which health care is equipped to tackle more serious situations.

 The healthcare team will suffer less from extenuating periods of adverse field work and, consequently, be able to deliver better assistance when needed due to conditions that propitiate this improved performance.

 These factors, together, impact the entire community, creating a better environment. This is how evolution is done and how small steps can, in the end, create an enormous transformation in society.

Our technology, as mentioned before, can be divided into two main parts. The hardware part involves the sensors, the antennas installed on the ship, and the devices that allow communication between multiple users over long distances. The second part is the software, which evolves our application on the user’s cellphone, our platform accessed by the health team, and the software on the long-range devices.

The antennas installed on top of ships are composed of a starlink antenna, which creates a link with low-orbit satellites, and some wireless amplification routers (which extend the range of this internet signal). It is important to keep in mind that these electromagnetic waves emitted by the repeater can reflect on the water surface, extending even more the original range of this wireless repeater. This set of antennas is connected to the electrical supply in the ship but also has a pack of 18650 lithium-ion batteries, providing 6 hours of working after being disconnected from the power supply. This disconnection, as well as any other interference in normal functioning, is reported to our main platform with location and other telemetry data from the antenna. Authorities can eventually be informed.

The second part consists of LoRa devices, which are currently working in our prototype network created in a city. Currently, we use portable LILYGO TTGO ESP 32 devices with the software Meshtastic (an open-source software that allows a mesh arrangement between these devices) with some modifications that allow data sharing with specific integration of our LORAWAN Gateway for integration of this data created and flowing by the LoRa network. When the user’s phone has access to the internet, the device is not needed, and the data flows to the database via the internet.

These devices connect via Bluetooth with the user’s phone, synchronize the data from the application, and send it to the main network using the LoRa network. The data navigates this network until it reaches a gateway and migrates via the internet to our platform. We have on our implementation plan a migration for proprietary software on these devices to ensure stability and data protection after the migration to the second phase of our implementation.

The application on the patient’s phone consists of a receiver for the data from the sensors, which connect to the cellphone via Bluetooth (glucometer, blood pressure monitor, and an oximeter). In addition to that, the application allows patients to analyze their data if required. Other sections of the application offer direct communication with the healthcare team and another section where they can find informative content shared by their health provider specifically for their condition, such as recipes, workout tips, medication instructions, and information about the disease and the importance of correct treatment adhesion.

 The healthcare team’s platform, which works on desktops and can be accessed by the browser of mobile devices, works as a database with different types of data categorization beyond patient information, vital signs, and a communication channel (voice, messages, and video, when the internet link allows).

Having a multicultural and diverse team is one of the best ways to think about and develop a better future with different perspectives and with everyone in mind. This creates fair progress that includes not just common sense but also those who are different, minorities, and do not share the same principles as us.

 Having this in mind, I always try to listen to every single opinion, which has been shown to be the best way to build a strong idea and concept. Having this as one of our base foundations changed our workflow to a much better one. Having different backgrounds composing our team, as well as different ages, religions, colors of the skin, and sexual orientations, makes us a very diverse team already. However, there is always room for new ideas and new thinking.

 We are open to engagement for anyone who wants to become part of our team. Currently, we cannot offer payment due to our initial stage, but having an equal and fair system of salary and retribution is one of our main goals. It would be illogical if we, in a project that fights for better equity, had an unfair and excluding internal organization.

The Life Sign Project is a business-to-government model that focuses on offering a connection between patients and the already designated healthcare teams covering isolated areas in developing countries, such as Brazil. Our markets are municipalities due to the organization of the Brazilian health system, which designates the control of low-complexity healthcare to the city administration. This structure of organization is also found in other Latin American countries.

By focusing on the government, we will provide a service that fits into the health infrastructure. It is important to keep in mind that this infrastructure already exists and will achieve a higher level of capillarity with minimal costs and changes if a solution such as ours facilitates the last-mile connection. Therefore, the demand for such a product would be very high.

When the costs of a single emergency transportation of a patient with an easily preventable condition are compared with the cost per user of our solution, the difference is enormous—enough to pay for one year of follow-up for 600 families in the region. There is a clear advantage to focusing on prevention here.

 To do so, we have reached out to some municipalities and telehealth centers to design a product that fits into their workflow. They are giving us great feedback and showing big interest in what we are developing so far, offering their locations and infrastructure at no cost to host our future pilot study.

 After studying how we will charge for our service, we concluded that the best way is to use the number of patients using our system. It starts with a base price for a minimal number of users for a viable operation, calculated based on specific factors like geography, the number of devices, and the number of sensors in the kit. This will be agreed upon in a contract for two years for each area covering these users.

 This cost can be reduced with more patients incorporated into our network, which is good for the municipalities and creates a stronger network for our system. The cost per family drastically reduces after the first year (which is our pilot), reaching a value of U$ 1.20 per family per month after the third year (it started at U$ 3.72 on the pilot).

 Having our initial field in the Amazon allows us to create a very strong and resilient business model due to the difficulties present in this region with its fragile healthcare system. It allows a posterior expansion in an easier way than what would occur if we tried the opposite (in a context that does not match our target population and market).

There are some companies offering internet (via satellite or radio) in the Amazon currently. However, the price is very high, the service is unreliable, and it requires a complex installation with their own personnel. These factors make it impracticable for most of the low-income population in this area, for any telehealth company, and for the government to pay for telehealth services with great capillarity.

The Life Sign Project has an implementation plan composed of three phases. The first phase consists of our pilot, when we will start operations with twenty families. The second phase is our expansion (during the second and third years), when we will establish our product with changes from phase 1 (pilot), focusing on enhancing our penetration into new areas. The last one consists of several cities being reached and novel technologies being implemented.

During conversations with local telehealth specialists and teams from these areas, we defined one to host our pilot that shares the same difficulties found in other isolated regions in the Amazon. We will join the healthcare team during routine visits to the region to provide our bundle (devices and sensors) and give instructions on how to utilize the user platform for 75 families (25 in the villages and 50 in remote areas).

After that, we will follow them remotely with their health team for nine months and collect feedback (from both sides) on how our product is working and how it could be optimized. This information will help us make some adjustments for the next phase.

The cost of this entire first year of operations will be around $15,000, including the initial implementation costs, the hardware needed, and the software refinement, which represents most of this cost ($9,000). This refinement will complement our system with features reviewed by professionals to ensure cybersecurity and data privacy compliance before it reaches the public. This hardware and software infrastructure will serve us during all our future operations, making the cost significantly lower with more users. The implementation costs make the first year in each zone the most expensive.

 After that, with a working system, nine other zones with an increment in the number of families (150 each) and the same characteristics as the first one will host our expansion (some of them already defined). In this phase, we will start charging the municipalities for the service. As said before, the cost will decrease as the phase progresses, going from $3,72 to $2,00 per family per month at the end.

 In the last phase, when economic sustainability is reached, we will have the lowest price and the best performance yet due to increments in our network and dilution of the costs (around $1,20 per family per month). The cost of operations will also be reduced by the implementation of better tools developed during Phase 2 and the cheapening of components. So, the costs per user can be lower.

In this phase, new approaches will be used to create a truly robust and versatile network with extended capabilities that responds to specific demands in real time, such as dedicating a high level of health assistance through hours of high-speed connection to a specific area. It will be possible by using a system that consists of solar-powered drones with several hours of autonomy working as a platform for our high-speed link. Our team is currently building the first prototype.

When we start thinking about how to create a solution to the gap between patients and the health system, we consider several solutions, and initially, only the satellite link installed on ships passing through this region was our plan. It is, by itself, a great solution for this problem. However, during the research phase, we found other peripheral solutions that consolidated our approach and reduced costs. The decentralized network is one of these solutions.

With these improvements, we are optimizing our product to the point that its cost for an entire village is several hundred times less than what our market spends on only one patient being transported to a big city by plane and hospitalized (costing around $10.000 and $30.000) due to an avoidable disease with a simple prevention such as a hypertensive emergency or organ failure due to chronic hypertension.

 Currently, we are not operating commercially, but we invested some money from the team members to create our prototypes to allow us to start testing our technology, which happened at a lower cost than expected. With funding, our team will be improved by adding new members with specific skills that we currently do not have, such as network-specialized IT professionals and a lawyer for legal counseling.

 Nonetheless, during some talks with municipalities and health authorities, interest was shown in financing our project to be incorporated in that specific city. We do not accept these offers because it would limit our operations to only one city and we would be incorporated into their administration. For now, we want to be able to operate freely from the bonds of a local institution, whether it's public or private, so that we can innovate by seeing our local reality through our own innovative perspective and be able to think of possibilities and solutions without the bias of past projects and decisions.